COMPARISION OF DEXMEDETOMIDINE AND MAGNESIUM SULPHATE AS AN ADJUVANT TO BUPIVACAINE FOR TRANSVERSE ABDOMINIS PLANE BLOCK IN CAESAREAN DELIVERY FOR POST OPERATIVE ANALGESIA

Abstract

Introduction: Postoperative pain relief can be achieved by a variety of techniques including peripheral nerve block, parenteral NSAIDS, epidural analgesia, neuraxial local analgesics. The transverse abdominis plane block is a local anaesthetic block used to provide analgesia to the anterior and lateral abdominal wall.

Methods: The prospective randomised study carried out in 90 patients belonging to ASA 1, 2 posted for LSCS and divided into 3 groups,30 patients each. All patients receive TAPP block at the end of surgery. Group B received TAPP block with 18 ml 0.25% bupivacaine 18ml with 2ml NS. Group BM received 0.25% bupivacaine with 1.5ml (150mg) of magnesium sulfate and 0.5ml of NS. Group BD received 20ml of bupivacaine with dexmedetomidine 0.5 mcg/kg with 2ml NS.

Results: Combination of 0.25% bupivacaine and 150mg magnesium sulfate and combination of 0.25% bupivacaine and 0.5mcg/kg dexmedetomidine provides longer duration of analgesia compared to 0.25% bupivacaine alone.

Conclusion: Maximum duration of analgesia observed with combination of 0.25% bupivacaine and magnesium sulfate 150mg.Thus TAPP block when used as a part of multimodal regime provided superior analgesia up to 48 hours and reduced the need of opioid analgesia following LSCS under spinal anaesthesia.